Business Account Application and Standard Forms

Transcription

1 Business Account Application and Standard Forms

2 Table of Contents Page Application Instructions and General Information... 3 Section 1 Company Information... 4 Section 2 Nature of Business Declaration... 6 Section 3 Account and Product Application... 9 Section 4 Business Indemnity and Waiver Form - Communication by Electronic Means Section 5 Declarations and Agreements Appendix: Certified Copies and Additional Information I Certified Copy of Corporate Resolution II Certified Copy of Partnership Resolution III Certified Copy of Trustee Resolution IV Non-Incorporated Body/Sole-Trader Resolution V Certified Copy of Corporate Incumbency VI Non-Incorporated Body Incumbency of 21

3 Application Instructions Welcome to HSBC Bank Bermuda Limited (HSBC). Our objective is to make the application process for HSBC accounts and other products and services as easy as possible. Full details of our services and products are available at Please pay close attention to the instructions to avoid delays. To apply for an account and/or products with us, please follow the instructions below. 1. Complete application form This application form must be completed. Refer to the appropriate checklist to determine which sections should be completed based on entity type. 2. Complete appropriate checklist and submit required documentation The appropriate checklist must be completed and originals or original certified copies of required documents must be submitted along with your application 3. General Information How to get documents certified For a photocopied document to be considered certified, a person of an approved profession must certify it. Professions approved by HSBC for this purpose are: Officer, Vice President of a bank or any HSBC employee at no additional charge. A lawyer, notary public, accountant or actuary who is a member of a recognised body. A Member of the Judiciary or a Senior Civil Servant. An officer of an embassy, consulate, high commission of the country of issue. The person certifying the documents must include the following details on all the documents they certify for both a drop off and mail in application: and date Name and address printed clearly in BLOCK CAPITALS, and professional position or capacity, e.g. lawyer A statement that says I have seen the original document and I certify that this is a complete and accurate copy of the original. The original certified copy should be included with the application. Submitting the application Once completed, please return the application and accompanying documents to your relationship manager. For assistance please contact your relationship manager or contact HSBC on the following telephone numbers: For HSBC Business For all HSBC Corporate or visit Thank you for choosing HSBC 3 of 21

4 Section 1 - Company Information Registered Name Business Name The legal name of the customer business, sole trader or other entity (including non-business entity) The trading name of the customer business, only required if this is different from the legal name TYPE OF ENTITY please tick Type of Entity Private Company Association Foundation Public Company Club Government/State Body Registered Partnership Charity Other, please specify Unregistered Partnership Sole Trader Non-Government Organisation Trust Entity Level Detail Date of Incorporation Registration Number Country of Incorporation Website Address Name of Auditor If the entity is a publicly traded company Name of Stock Exchange Trading Symbol Entity Level Detail Industry Insurance Construction Funds Banking Telecom Automotive General Trading Shoes/footwear Furniture Houseware/Hardware Machinery/Equipment Transportation Electronics Corporate Service Provider Petrochemicals/Plastics/Chemicals Textiles/Garments Real Estate Retail/Wholesale Food Management Company Other, please specify Registered Address (P.O. Box is not acceptable) Contact Name Company Name Address 1 Address 2 City/State Country Postal/Zip Code Telephone Fax 4 of 21

5 Mailing Address Same as the Registered Address Yes No (If you ticked No, please complete below section) Contact Applicant Corporate Service Provider Management Co Other Contact Name Company Name Address City/State Country Postal/Zip Code Telephone Fax Operating Address/Principal Place of Business Same as the Registered Address Yes No Same as the Mailing Address Yes No (If you ticked No, please complete below section) Years in Address Greater then 3 years Less than 3 years(please provide previous) Contact Name Company Name Address City/State Country Postal/Zip Code Telephone Fax Previous Operating Address (if less than 3 years) Same as the Registered Address Yes No Same as the Mailing Address Yes No (If you ticked No, please complete below section) Contact Name Company Name Address City/State Country Postal/Zip Code Telephone Fax Key Contact Details & Address Contact Applicant Corporate Service Provider Management Co Other Contact Name Title/ Held Company Name Address City/State Country Postal/Zip Code Telephone Fax 5 of 21

6 Other HSBC Relationship(s) Relationship Details Does the company or any of its underlying subsidiary companies or any of its holding companies hold a banking relationship with any HSBC Group Member? Yes No If Yes, please indicate which company(ies) and which HSBC Group Member? Company Name HSBC Member Relationship Manager Company Name HSBC Member Relationship Manager Company Name HSBC Member Relationship Manager Section 2 - Nature of Business Declaration Describe the products and services which your business provides to its clients and any other activities generating revenue for your business/entity. Please describe the products and services of the group in which your entity is a subsidiary (If applicable). Initial Source of Wealth Please describe the business activity or situation that generated the initial source of the Company s accumulated capital, not just the portion that is invested with the Bank for the initial deposit/account opening or investment. Ongoing Source of Wealth Please describe the ongoing business activities or situation that will generate the funds that will be deposited into the account or premium paid/ cash invested. 6 of 21

7 Number of Employees (including volunteers, contracted workers, etc) Zero to Over 100 Does your company have any subsidiary or branch? Yes No If you have selected Yes, please provide the list of subsidiary(ies) or branch(es) and the countries in which they operate: Name Type (Subsidiary or Branch) Country of Operation Please provide your total revenue per year for the entity (If your company is a startup, please provide projected revenue) If your company manages or administers third party funds, please provide us with your total Assets under Management or Assets under Administration 7 of 21

8 Personal Details Form One form to be completed for each Director, Officer, Shareholder, Beneficial Owner, Authorised Signatory, Company Secretary, Trustee, Settlor, Protector, Founder or Direct Appointee. Full legal name Please state your connection(s) to the company below: If Beneficial Owner - % of Ownership Known as (if different) Date of Birth Place of Birth Nationality(ies) Tax Residency(ies) Residential Address How many years at this address? If less than 3 years please provide previous address Address Telephone Number Passport Information Country of issue Number Expiration Date HSBC Personal Account Number (if applicable) Beneficiary Details - Source of Wealth Please describe the activity(ies) or transaction(s) which generated your individual accumulated capital. Signatory Sample If you are the authorised signatory, please provide your signature below. 8 of 21

9 Section 3 - Account and Product Application Account Name, Number and Account Opening Instructions (This section is per account; please print out additional forms if more than one account is required) Customer Name Customer Number - Sub Account Name Please choose one of the following three options: BMD Cash Management Account (with cheques) USD Cash Management Account (with cheques) Cash Management Account (without Cheques) in the following currency (please choose one currency from the following list): BMD USD GBP ZAR EUR AUD CAD CNY CHF DKK THB JPY NOK NZD SEK SGD HUF HKD Will the account operate under the same mandate as an existing HSBC Account? Yes No Yes, please specify existing account number No, please attach the certified copy of the resolution establishing the new mandate together with a completed signature form per signatory. See Appendix 1. Visa Business Credit Card Required? Yes No (If you choose Yes, one of our representatives will contact you upon receipt of this application) What will this account be used for? (For example receipt of salary, pensions, money transfer, business sales, commissions, profits, others) Initial Source of Funds Please name the individual or entity that is providing the initial deposit(s) What is the relationship between this party and the applicant? What type of transaction will be used to deposit the initial fund? What is the expected amount? If it is a wire transfer, please provide the name of the bank and country from which the transfer will be made Intention to Make Cash Deposits Yes No Purpose of Cash Deposits (For example the customer business is cash oriented / business receipts are in cash) Expected Value Range Frequency Currencies Involved in Cross Border Payments 9 of 21

10 Incoming Funds Please list details of expected inward payments into this account (eg. sales, donations, investment income etc) Counterparty 1 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % Value of Total Revenue Counterparty 2 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % Value of Total Revenue Counterparty 3 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % Value of Total Revenue Counterparty 4 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % Value of Total Revenue If the Name of the Entity/Type of Business is not known for any of the above, please explain below: (Please print additional pages if needed.) 10 of 21

11 Outgoing Funds Please list details of expected outward payments into this account (eg. sales, donations, investment income etc) Counterparty 1 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % of Total Expenditure Counterparty 2 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % of Total Expenditure Counterparty 3 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % of Total Expenditure Counterparty 4 Name of Entity Type of Entity Country of Operations Expected Value Range Per Transaction Frequency Type of Transactions (e.g. Wire, Cash, Cheque Deposit) Reason for Payment % of Total Expenditure If the Name of the Entity/Type of Business is not known for any of the above, please explain below: (Please print additional pages if needed.) 11 of 21

12 Section 4 - Business Indemnity and Waiver Form - Communication by Electronic Means Account means each account the Customer holds with the Bank from 4. The Customer consents to the Bank making an audio recording of time to time. any telephone call, or a record of any electronic communication Bank means HSBC Bank Bermuda Limited, its subsidiaries and its the Bank may have with the Customer to preserve the context of affiliates. all Instructions or other information the Customer provides to the Claims means any actions, proceedings, causes of action, or other Bank. claims of any kind against the Bank. 5. The Customer acknowledges that it is solely and fully responsible Customer means the Account holder, the organisation named on the for the use of the Customer s Debit Card or Security Code. The Business Account Application and related resolution for each account. Bank is not required to confirm the identity or authority of any For a partnership, joint venture, unincorporated association, or sole trader, person using the Customer s Debit Card or Security Code to Customer includes every general partner, joint venture participant, make transactions, and the Bank shall have no liability of any kind member, or individual, respectively, of the organisation jointly and severally. whatsoever to the Customer if the identity of the person is not correct or if the person using the Customer Debit Card or Security Debit Card means each debit card or other financial services card that Code is not authorised to do so. the Bank issues to the Customer (but not any of its credit cards) that is used to identify the Customer and to authorise transactions on its accounts, and 6. The Bank will not be liable for any Liabilities suffered by the includes all or any part of a Debit Card number. Customer or by a third party because of any failure of or refusal by the Bank to give effect to any Instructions or for any delay in Electronic Means includes communications sent by , facsimile, implementing Instructions regardless of the reasons for such telephone, and computer or by the use of scanned or digital signatures or failure, refusal or delay (other than the Bank s gross negligence or any other electronic means. intentional misconduct). Instructions means any instruction that is or reasonably appears to be 7. The Customer has taken all necessary action to authorise the entry given to the Bank by the Customer. into and performance of this Indemnity; the person(s) who sign Liabilities means all costs, expenses, charges, debts, liabilities, below have been duly authorised to sign the Indemnity on behalf damages, demands, obligations, fees, levies, duties or penalties whether of the Customer; the Indemnity and such authorisations are in direct or indirect, fixed, contingent or otherwise, suffered or incurred by the accordance with the applicable constitutional documents of the Bank. Customer. Security Code means any Customer identification code, including any 8. The Customer hereby waives all Claims it may have against PIN (personal identification numbers), password, digital certificate, token the Bank as a result of the use of the Customer s Debit Cards or security device, access code, logon user name or other identification or Security Codes, the Bank acting on Instructions or the Bank or memorable data, which permits the Customer access to an Account or otherwise performing its obligations under this Agreement (except other Bank products or services. if the Bank has been grossly negligent or acted with intentional In consideration of the Bank agreeing to act on Instructions by Electronic misconduct). Means of the Customer, the Customer agrees to the following: 9. The Customer releases and agrees to save the Bank harmless from 1. The Customer authorises the Bank to accept without any further and against any and all Claims and Liabilities (to the Customer or verification, and the Customer agrees to be responsible for and any third party) the Bank incurs or suffers as a result of the Bank indemnify the Bank against and save the Bank harmless from any acting on Instructions, refusing to give effect to any Instructions damage the Bank may suffer as a result of acting on Instructions, or not accepting any agreements or documents, or for any delay in agreements and documents for transactions submitted to the Bank by implementing any Instructions (regardless of the reasons for failure, Electronic Means if the Bank believes that the Instructions have come refusal or delay), or otherwise performing its obligations hereunder from the Customer or its agent. Whether or not such Instructions, except of the Bank has been grossly negligent or acted with documents and agreements were actually authorised or valid, the intentional misconduct. Customer acknowledges that if the Bank acts on any Instructions, 10. The Customer agrees that it shall review statements or other agreements and documents submitted by Electronic Means it shall notifications with respect to Accounts within thirty days and as evidence the belief of the Bank that the Instructions have come from required pursuant to any agreement with the Bank. The Bank shall the Customer or its Agent. have no liability of any kind whatsoever for any Claims or Liabilities 2. The Customer agrees that what in the Bank s reasonable determination which would or should have been discovered by the Customer had appears as the Customer s signature on Instructions by Electronic it reviewed the statements or notifications within thirty days, and Means or documents (whether or not actually signed by the Customer) the Customer waives all Claims it may have against the Bank and binds the Customer legally and makes it responsible to the same extent releases the Bank from any Claims and Liabilities that the Bank and effect as if the Customer had given original signed Instructions would have to the Customer arising or contributed to after the (except if the Bank has been grossly negligent or acted with wilful time that the statements or notifications for the Account should misconduct). have been reviewed, whether or not any of the Claims or Liabilities 3 There may be some types of Instructions or documents the Bank will resulted from the negligence of the Bank. not accept by Electronic Means, and the Customer understands that 11. This indemnity will be governed by and construed in accordance the Bank reserves the right to refuse any Instructions by Electronic with the laws of Bermuda. Means, agreements or documents in its sole discretion. 12 of 21

13 Signed for and on behalf of the Customer Customer Name Full name of authorised signatory Full name of authorised signatory Full name of authorised signatory Full name of authorised signatory Notes: Name Refers to the name of the clients in which business transactions will be conducted Entity Type Example would be Individual, Corporation, Financial Institution, Partnership or Government Country of Operation Refers to the country of operations of the client or counterparties (e.g. UK, Bermuda, Russia) % of Sale/Revenue & % of Expenditures If dollar value is provided, please give the details of total annual sales/expenditures in USD 13 of 21

14 Section 5 - Declarations and Agreement I/We confirm to you the following: 1. I/We confirm that the information provided on this Application is complete and accurate. 2. I/We declare that the Account(s) and Product(s) will only be used for legal purposes. 3. I/We agree to inform you of any changes in my/our status or the status of the Customer that could affect the operation of the Account(s), including change of address. 4. I/We confirm that I/we have read and agree to the terms and conditions of the Accounts and Products for which I/we have applied and I/we confirm to be bound by such terms and conditions and any changes that may occur from time to time. 5. I/We confirm and agree that I/we am/are responsible for reviewing upon receipt, all account statements or other notifications relating to an Account and, if I/we fail to do so, the Bank will not be liable to the Customer for any losses incurred after the time that such information should have been discovered. 6. I/We confirm that the Customer has taken all necessary action to authorise the entry into and performance of this Application, the person(s) who sign below have been duly authorised to sign the Application on behalf of the Customer, the Application and such authorisations are in accordance with the applicable constitutional documents of the Customer. Signed for and on behalf of the Customer Authorised Signatory One Print name Authorised Signatory Two (if applicable) Print name Authorised Signatory Three (if applicable) Print name Authorised Signatory Four (if applicable) Print name \ HSBC Bank Bermuda Limited 37 Front Street Hamilton HM 11 Bermuda IDHSBC September 2016 HSBC Bank Bermuda Limited. All rights reserved. Issued by HSBC Bank Bermuda Limited which is licensed to conduct Banking and Investment Business by the Bermuda Monetary Authority. 14 of 21

15 Appendices 15 of 21

16 Appendix I - Certified Copy of Corporate Resolution If you are opening a Bank account in the name of a Company I,, Secretary/ Director of (the Company ), a Company duly organised and existing under the laws of and having its registered address at hereby certify that the following is a true and complete copy of resolutions duly adopted by the Board of Directors of the Company at a meeting thereof duly convened and held on at which a quorum was present and voting throughout and such resolutions are now in full force and effect and are in accordance with the provisions of the Articles or Memorandum of Association or Bye-laws as applicable of the Company. RESOLVED that HSBC Bank Bermuda Limited and its subsidiaries and affiliates (the Bank ) be and hereby are designated as a depository of funds and assets of the Company and that accounts with the Bank be opened and operated on the terms and conditions applicable from time to time to such accounts. FURTHER RESOLVED that the directors have read and reviewed in detail the Business Account Operating Agreement and the Business Indemnity and Waiver Form, understand them and approve the terms thereof. FURTHER RESOLVED that it is the responsibility of the Company to review account statements and other notifications relating to any of the accounts of the Bank and, should the Company fail to review such account statements in accordance with the terms of the Business Account Operating Agreement, the directors acknowledge that the Bank shall have no liability to the Company for any claims, losses, damages or any other amounts incurred by the Company if it fails to notify the Bank of any errors or omissions in the account statements or other documentation relating to any of the accounts within the time period required in the Business Account Operating Agreement. FURTHER RESOLVED that the Bank be and is hereby authorised to honour Instructions issued or Instruments made, drawn, endorsed or executed by or on behalf of the Company. The following are Authorised Persons authorised on behalf of the Company to approve and execute the Business Account Application, approve and adopt the Business Account Operating Agreement, enter into any other agreements with the Bank for products and services the Authorised Persons consider in the best interests of the Company and approve. The Authorised Persons are further authorised to act in relation to the issuance of Instructions or Instruments relating to the accounts or transactions of the Company. The combination of individuals authorised to give Instruction to the Bank is: (please tick relevant box) Any one of the following Secretary/Director Any two of the following The first named person below and any one other of the persons below Authorised Signatory One Authorised Signatory Two (if applicable) Authorised Signatory Three (if applicable) Authorised Signatory Four (if applicable) 16 of 21

17 Appendix II - Certified Copy of Partnership Resolution If you are opening a Bank account in the name of a Partnership At a meeting of the, a Partnership organised under the laws of, held on,we, the undersigned, constituting all the General Partners, hereby: RESOLVED that HSBC Bank Bermuda Limited and its subsidiaries and affiliates (the Bank ) be and hereby are designated as a depository of funds and assets of the Partnership and that accounts with the Bank be opened and operated on the terms and conditions applicable from time to time to such accounts. FURTHER RESOLVED that the Partners have read and reviewed in detail the Business Account Operating Agreement and the Business Indemnity and Waiver Form, understand them and approve the terms thereof. FURTHER RESOLVED that it is the responsibility of the Partnership to review account statements and other notifications relating to any of the accounts of the Bank and, should the Partnership fail to review such account statements in accordance with the terms of the Business Account Operating Agreement, the General Partners acknowledge that the Bank shall have no liability to the Partnership for any claims, losses, damages or any other amounts incurred by the Partnership if it fails to notify the Bank of any errors or omissions in the account statements or other documentation relating to any of the accounts within the time period required in the Business Account Operating Agreement. FURTHER RESOLVED that the Bank be and are hereby authorised to honour Instructions issued or Instruments made, drawn, endorsed or executed by or on behalf of the Partnership. The following are Authorised Persons authorised on behalf of the Partnership to approve and execute the Business Account Application, approve and adopt the Business Account Operating Agreement, enter into any other agreements with the Bank for products and services the Authorised Persons consider in the best interests of the Partnership and approve. The Authorised Persons are further authorised to act in relation to the issuance of Instructions or Instruments relating to the accounts or transactions of the Partnership. The combination of individuals authorised to give Instruction to the Bank is: (please tick relevant box) Any one of the following Partners Any two of the following The first named person below and any one other of the persons below We agree, individually and on behalf of the Partnership, that notwithstanding any modification or termination of the power of any General Partner to represent the Partnership or any dissolution or termination of the Partnership, whether by expiry of the partnership agreement, by death, by bankruptcy or resignation of any partner, or otherwise, or any notice thereof that the Bank may receive, this authority shall continue and all acts done and performed thereunder shall be binding upon each of us individually, our legal representatives, and upon any partners whose signatures do not appear below until notice in writing signed by one or more of the undersigned shall have been received by the Bank, which notice shall not affect our obligation with regard to acts done and performed hereunder prior to the Bank s receipt of such notice. Authorised Signatory One Authorised Signatory Two (if applicable) Authorised Signatory Three (if applicable) Authorised Signatory Four (if applicable) 17 of 21

18 Appendix III - Certified Copy of Trustee Resolution If you are opening a Bank account in the name of a Trust At a General Annual Special meeting of the held on it was: RESOLVED that HSBC Bank Bermuda Limited and its subsidiaries and affiliates (the Bank ) be and hereby are designated as a depository of funds and assets of the Trust and that accounts with the Bank be opened and operated on the terms and conditions applicable from time to time to such accounts. FURTHER RESOLVED that the Trustees of the Trust have read and reviewed in detail the Business Account Operating Agreement and the Business Indemnity and Waiver Form, understand them and approve the terms thereof. FURTHER RESOLVED that it is the responsibility of the Trustees of the Trust to review account statements and other notifications relating to any of the accounts of the Bank and, should the Trustees of the Trust fail to review such account statements in accordance with the terms of the Business Account Operating Agreement, the Trustees acknowledge that the Bank shall have no liability to the Trust for any claims, losses, damages or any other amounts incurred by the Trust if it fails to notify the Bank of any errors or omissions in the account statements or other documentation relating to any of the accounts within the time period required in the Business Account Operating Agreement. FURTHER RESOLVED that the Bank be and is hereby authorised to honour Instructions issued or Instruments made, drawn, endorsed or executed by Trustees of the Trust on behalf of the Trust. The following are Authorised Persons authorised on behalf of the Trust to approve and execute the Business Account Application, approve and adopt the Business Account Operating Agreement, enter into any other agreements with the Bank for products and services the Authorised Persons consider in the best interests of the Trust and approve. The Authorised Persons are further authorised to act in relation to the issuance of Instructions or Instruments relating to the accounts or transactions of the Trust. The combination of individuals authorised to give Instruction to the Bank is (please tick relevant box) Any one of the following Trustee Any two of the following The first named person below and any one other of the persons below Authorised Signatory One Authorised Signatory Two (if applicable) Authorised Signatory Three (if applicable) Authorised Signatory Four (if applicable) 18 of 21

19 Appendix IV - Non-Incorporated Body/Sole Trader Resolution If you are opening a Bank account in the name of a Non-Incorporated Body/Sole Trader At a General Annual Special meeting of the held on it was RESOLVED that HSBC Bank Bermuda Limited and its subsidiaries and affiliates (the Bank ) be and hereby are designated as a depository of funds and assets of the Non-Incorporated Body and that accounts with the Bank be opened and operated on the terms and conditions applicable from time to time to such accounts. FURTHER RESOLVED that the Authorised Persons have read and reviewed in detail the Business Account Operating Agreement and the Business Indemnity and Waiver Form, understand them and approve the terms thereof. FURTHER RESOLVED that it is the responsibility of the Non-Incorporated Body to review account statements and other notifications relating to any of the accounts of the Bank and, should the Non-Incorporated Body fail to review such account statements in accordance with the terms of the Business Account Operating Agreement, the Non-Incorporated Body acknowledges that the Bank shall have no liability to the Non- Incorporated Body for any claims, losses, damages or any other amounts incurred by the Non-Incorporated Body if it fails to notify the Bank of any errors or omissions in the account statements or other documentation relating to any of the accounts within the time period required in the Business Account Operating Agreement. FURTHER RESOLVED that the Bank be and is hereby authorised to honour Instructions issued or Instruments made, drawn, endorsed or executed by or on behalf of the Non-Incorporated Body. The following are Authorised Persons authorised on behalf of the Non-Incorporated Body to approve and execute the Business Account Application, approve and adopt the Business Account Terms and Conditions, enter into any other agreements with the Bank for products and services the Authorised Persons consider in the best Interests of the Non-Incorporated Body and approve. The Authorised Persons are further authorised to act in relation to the issuance of Instructions or Instruments relating to the accounts or transactions of the Non-Incorporated Body. The combination of individuals authorised to give Instruction to the Bank is: (please tick relevant box) Any one of the following Any two of the following The first named person below and any one other of the persons below Authorised Signatory One Authorised Signatory Two (if applicable) Authorised Signatory Three (if applicable) Authorised Signatory Four (if applicable) 19 of 21

20 Appendix V - Certified Copy of Corporate Incumbency (also known as Register of Directors and Officers) I,, Secretary/Director of (the Company ), a Company duly organised and existing under the laws of hereby certify that at the meeting of the Company held on Full legal name/date of birth/country of birth/nationality(ies) the following Directors and Officers were duly elected: held Witness my hand and seal of the Company, this day of year Secretary/Director 20 of 21

21 Appendix VI - Certified Copy of Non-Incorporated Body Incumbency At a General Annual Special meeting of the held on the following officers were duly elected: Full legal name/date of birth/country of birth/nationality(ies) held The Bank will be advised immediately should there be any resignations, appointments or changes. The Bank will be advised immediately should there be any appointments or changes. Print name Print name For Bank Use Only HSBC Bank Bermuda Limited 37 Front Street Hamilton HM 11 Bermuda IDHSBC September 2016 HSBC Bank Bermuda Limited. All rights reserved. Issued by HSBC Bank Bermuda Limited which is licensed to conduct Banking and Investment Business by the Bermuda Monetary Authority. 21 of 21